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PubMed1998

[Primary shortening--secondary lengthening. A new treatment concept for reconstruction of extensive soft tissue and bone injuries after 3rd degree open fracture and amputation of the lower leg].

The main problem in major limb replantation--especially of the lower extremity--is an extensive bone- and soft-tissue loss. The traditional replantation concept tries to preserve the initial limb length; only a small shortening is accepted. To avoid a more extensive shortening, often insufficient debridement at the time of replantation is carried out. After successful revascularisation, bone and soft-tissue defects will be reconstructed according to the principles of staged reconstruction. Especially segmental nerve defects of more than one major peripheral nerve and severe skin and muscle loss necessitate extensive secondary grafting procedures. This often leads to a prolonged hospitalisation and a high complication rate. In 1951, Lorenz Böhler described the deliberate extremity shortening as a method of therapy in segmental combined bone-soft-tissue defects of the extremities. No additional surgical procedure were necessary to treat the soft tissue defect. A functional but shortened extremity was the result. With Ilizarov's principle of callus distraction he proved in an extensive experimental and clinical study the possibility to lengthen extremities without functional damage up to 20 cm. A new reconstruction concept--"concept of primary shortening with secondary limb lengthening"--for the treatment of amputation and/or amputation-like injuries was created by combining both principles mentioned above. At the time of replantation (reconstruction), deliberate shortening is carried out in order to reduce soft-tissue and/or bone defect or to enable primary nerve repair. Moreover, the aggressive debridement leads to a reduction of the local complication risk (wound healing disturbance, infection) and the potential systemic complications (crush-syndrome, ischemia-reperfusion-syndrome) after revascularisation of a large tissue bloc. Six to twelve months after replantation, secondary limb lengthening is started using an external or internal (= programmable intramedullary nail) distraction device. Since 1985, twelve patients (six macroamputations and six third-degree open fractures of the lower leg) have been treated using the "concept of primary shortening with secondary limb lengthening". Indications, operative technique, and results are shown and discussed, comparing this new concept to the traditional "concept of staged length-reconstruction" with extensive free tissue reconstruction and secondary nerve grafting.

Adult↗
PubMed1997

Distinguishing multiple dimensions of conceptions of ability: implications for self-evaluation.

Three separate lines of research have suggested that conceptions of ability may play a key role in the development of self-evaluation. Each line has focused on a different dimension of conceptions of ability: conceptions of ability as uncontrollable, conceptions of ability as constant, and conceptions of ability as capacity. Unfortunately, there has been little attention to the convergences and divergences among the 3 dimensions. The present study examined this issue in 236 second- through fifth-grade children. Children indicated the extent to which they conceived of ability as uncontrollable, as constant, and as capacity. Two forms of self-evaluation (performance following failure and the extent to which self-perceptions of competence converge with external indicators of competence) were investigated. In addition, cognitive competence was assessed. The near-zero correlations, 3-factor solution yielded by confirmatory factor analysis, variability in age-related differences, differential links to cognitive competence, and diverse forms of self-evaluation among the 3 dimensions suggested that the 3 are relatively distinct, and that they may play different roles in the development of self-evaluation. Moreover, the 3 dimensions appear to interact with one another to influence self-evaluation.

Aptitude↗
PubMed1999

Binge eating severity, self-concept, dieting self-efficacy and social support during treatment of binge eating disorder.

OBJECTIVE: In treatment of binge eating, measures of self-concept, eating self-efficacy, and social support were examined at 0, 6, and 18 months to determine if improvements in these variables were associated with reductions in binge eating severity. METHOD: Obese adult females (N = 125) were treated for 6 months, with 12 months of maintenance meetings. The Binge Eating Scale (BES), Tennessee Self-Concept Scale (TSC), Dieter's Inventory of Eating Temptations (DIET), and a social support measure (SocSup) were used. RESULTS: Over the first 6 months, improvements in BES were associated with improvements in the TSC and DIET. Over 18 months, improvements in BES were associated with improvements in the TSC, DIET, and SocSup. DISCUSSION: Therapy for binge eating should result in improvement in self-concept and eating self-efficacy, as well as reductions in binge eating. This study showed that self-concept and eating self-efficacy were associated with improvement in binge eating severity. The association with social support did not appear until long-term follow-up. Improvement in self-concept and eating self-efficacy may be processes leading to clinical improvement in this eating disorder, or they may result from changes in binge eating.

Adult↗
PubMed1979

The impact of chronic pain on the self-concept.

Compared self-concepts of three groups, medical patients, chronic low back pain patients and chronic head pain patients (N = 60) to determine (1) whether chronic pain patients have self-perceptions that differ from other medical patients; (2) whether changes in self-perception are limited to physical attributes and capacities; and finally (3) whether persons who suffer different types of chronic pain would have differing self-concepts. Significantly lower self-concepts were obtained from groups of head pain and low back pain patients. Self-concept patterns for the two pain groups were quite similar with the exception of two self-concept components that were significantly lower for the head pain group. Differences were explained in terms of loss of many normal functions and disruption of normal life-styles. Implications for treatment of pain patients and for training of health professionals were discussed.

Adult↗
PubMed1997

The abstraction of intervening concepts from experience with multiple input-multiple output causal environments.

The purpose of this article is threefold: (a) introduce a new paradigm for investigating how intervening concepts are learned, (b) report four new experiments that provide converging evidence for the acquisition of intervening concepts, and (c) propose a simple associative learning mechanism to account for the results. The new paradigm utilizes a stimulus-response-feedback task in which subjects learn trial by trial how a multivariate set of inputs maps into a multivariate set of outputs. The first two experiments use evidence based on a principal component analysis to replicate the finding that intervening-concept learning occurs spontaneously, but only in environments that contain an intervening factor. The next experiment provides a second converging line of evidence for this conclusion by showing that subjects can use an intervening concept to make accurate inferences to a new fourth output during a transfer test. The last experiment provides a third line of evidence by showing that subjects can use an intervening concept to make accurate inferences from a new fourth input. The results are explained by a hidden-unit connectionist learning mechanism that includes both accuracy and parsimony as learning objectives.

Association Learning↗
PubMed1997

Changes in self-concept and body image during alopecia induced cancer chemotherapy.

Alopecia as a result of cancer chemotherapy has been reported to cause changes to the self-concept and body image. In a prospective longitudinal study, self-concept and body image were analysed in 29 patients after histological confirmation of gynaecological malignancy, mainly ovarian cancer, who were assigned to receive a complete-alopecia-inducing PEC combination chemotherapy (cisplatin 50 mg/m2, epirubicin 60 mg/m2, and cyclophosphamide 500 mg/m2 in 1 day every 28 days). The analysis was performed before the commencement of treatment and repeated when alopoecia was complete and after completion of therapy when patients had already experienced regrowth of hair, using the Frankfurt self-concept scales (FSKN) and Frankfurt body concept scales (FKKS). Significant differences were observed in the various evaluation scales FSAP (general ability to solve problems), FSSW (general self-esteem), SGKB (state of health), and SKEF (physical fitness). For all scales the results worsened during chemotherapy but did not return to normal or improve when patients experienced regrowth of hair. It was found that 73.3% of the patients did not feel as self-confident as before treatment and that for 46.6% alopecia was the most traumatic side effect of chemotherapy. Since there is no chemotherapeutic regimen or any other effective treatment that can prevent alopecia, either of the following conclusions can be drawn: the observed differences may not be related exclusively to alopecia, but also associated with coping processes initiated by chemotherapy and perhaps enhanced by alopecia; or the changes persist even after the discontinuation of chemotherapy. Regrowth of hair and other adaptive processes do not normalize or improve the impaired body image and self-concept.

Adult↗
PubMed2002

Long-term memory for concepts in a California sea lion ( Zalophus californianus).

An adult California sea lion ( Zalophus californianus) with extensive experience in performing discrimination learning tasks was tested to evaluate her long-term memory for two previously learned concepts. An associative concept, that of equivalence classification, was retested after a retention interval of approximately 1 year. The sea lion had originally shown emergent equivalence classification with nonsimilarity-based classes of stimuli in a simple discrimination repeated-reversal procedure as well as in a matching-to-sample procedure. The 1-year memory test revealed no decrement in classification performance in either procedure. A relational concept, that of generalized identity matching, was retested after approximately 10 years. The sea lion had originally received trial-and-error exemplar training with identity matching-to-sample problems prior to transferring the concept to novel stimulus configurations. In the 10-year memory test, the sea lion immediately and reliably applied the previously established identity concept to familiar and novel sets of matching problems. These are the first reports of long-term conceptual memory in a nonprimate species. The experimental findings are consistent with a variety of observations of sea lions in natural settings, which indicate that natal sites, feeding areas, and individuals may be remembered over long periods of time.

Animals↗
PubMed1996

The red herring and the pet fish: why concepts still can't be prototypes.

There is a Standard Objection to the idea that concepts might be prototypes (or exemplars, or stereotypes): Because they are productive, concepts must be compositional. Prototypes aren't compositional, so concepts can't be prototypes. However, two recent papers (Osherson and Smith, 1988; Kamp and Partee, 1995) reconsider this consensus. They suggest that, although the Standard Objection is probably right in the long run, the cases where prototypes fail to exhibit compositionality are relatively exotic and involve phenomena which any account of compositionality is likely to find hard to deal with; for example, the effects of quantifiers, indexicals, contextual constraints, etc. In this paper, we argue that the Standard Objection to prototype theory was right after all: The problems about compositionality are insuperable in even the most trivial sorts of examples; it is therefore as near to certain as anything in cognitive science ever gets that the structure of concepts is not statistical. Theories of categorization, concept acquisition, lexical meaning and the like, which assume the contrary simply don't work.

Concept Formation↗
PubMed1985

Prediction of treatment response in pain patients: the illness self-concept repertory grid and EMG feedback.

Eighteen patients with chronic musculoskeletal pain completed a trial of EMG feedback where each subject was exposed to biofeedback, a control condition and a waiting list. Pain scores were determined pre- and posttrial, and the percentage change calculated for each subject. EMG activity and present pain measured during the trial gave an EMG/pain correlation for each patient. A repertory grid was completed by each patient at the pretrial evaluation. Repertory grid technique is a highly flexible way of measuring subjective data such as attitudes. The specific test used involved the patient in rating a series of 6 self-concepts across 8 'constructs' or concepts concerning illness and emotional distress. The resulting matrix of 48 ratings was analysed to produce a measurement of 'distance' between the self and ideal-self concepts. The major finding was that the self-ideal-self distance was significantly positively correlated with pain score changes by rank correlation. The self-ideal-self distance is essentially a measure of self-satisfaction or dissatisfaction and the results imply that patients who show a relatively greater degree of self-dissatisfaction are more likely to respond well to EMG feedback. In addition, patients with high EMG/pain correlations had a better outcome and this measure also correlated with pain scores. The relationship between self-concepts and EMG/pain correlations is discussed. The Illness Self-Concept Repertory Grid appears capable of predicting treatment outcome and shows promise as a prognostic tool.

Adolescent↗
PubMed1996

Self-concept, family functioning and problem type: a replication and extension of a study of clinic and non-clinic adolescents.

PURPOSE: This study replicates and extends previous research into self-concept and perceptions of family functioning held by clinic and nonclinic adolescents (1). METHOD: Thirty-five male and 28 female adolescents who sought help from a school counselor for family problems (n = 26) and for educational problems (n = 37) formed the clinic group. A nonclinic group was formed by adolescents who had experienced the same problems but had not sought help. The two groups were matched in terms of age and sex of respondents. Respondents' were clustered into two groups based on their ratings of family functioning. One cluster was characterised by high conflict, the other by high democratic parenting style and intimacy. RESULTS: Three MANOVAs with sets of scales (academic, social, and other scales) from the Self-Description Questionnaire II (2) as the dependent variables and with group (clinic/nonclinic), family functioning cluster, and sex as the independent variables confirmed the findings of the previous research. That is, there were multivariate effects on the three sets of self-concept scales. Significant univariate differences between the clinic and nonclinic groups were present for seven of the 11 individual self-concept scales, with higher mean ratings of self-concept shown by the nonclinic group. A range of sex effects and cluster effects were found, however, differences between the reported problem types did not show any consistent effect. CONCLUSIONS: The major point to be drawn from this research is the identification of a very clear difference between the self-concept of adolescents who seek professional care and those who do not.

Adolescent↗
PubMed2006

Mechanisms of same/different concept learning in primates and avians.

Mechanisms of same/different concept learning by rhesus monkeys, capuchin monkeys, and pigeons were studied in terms of how these species learned the task (e.g., item-specific learning versus relational learning) and how rapidly they learned the abstract concept, as the training set size was doubled. They had similar displays, training stimuli, test stimuli, and contingencies. The monkey species learned the abstract concept at similar rates and more rapidly than pigeons, thus showing a quantitative difference across species. All species eventually showed full concept learning (novel-stimulus transfer equivalent to baseline: 128-item set size for monkeys; 256-item set for pigeons), thus showing a qualitative similarity across species. Issues of stimulus regularity/symmetry, generalization from item pairs, and familiarity processing were not considered to be major factors in the final performances, converging on the conclusion that these species were increasingly controlled by the sample-test relationship (i.e., relational processing) leading to full abstract-concept learning.

Animals↗
PubMed2006

Relations of physical self-concept and self-efficacy with frequency of voluntary physical activity in preadolescents: implications for after-school care programming.

OBJECTIVE: This study aimed to test relations of physical self-concept and self-efficacy with voluntary physical activity in preadolescents enrolled in an after-school physical activity program. METHODS: Participants in the 2003 (n=41) and 2005 (n=84) versions of the Youth Fit For Life protocol and the control group (n=40) completed the Physical Self-Concept scale, the Exercise Barriers Self-Efficacy Scale for Children, and a recall of physical activity frequency at Weeks 1 and 12. RESULTS: Both treatment groups demonstrated significantly increased frequency of voluntary physical activity over 12 weeks. The 2005 version additionally demonstrated significant improvements in both physical self-concept and exercise barriers self-efficacy. Within the treatment groups, significant correlations between changes in physical self-concept and self-efficacy and physical activity sessions completed were found. Multiple regression indicated that 7% to 28% of the variance in voluntary physical activity was explained by the simultaneous entry of changes in physical self-concept and self-efficacy. CONCLUSION: Tenets of social cognitive and self-efficacy theory were supported and suggested that curricular elements of after-school care programming may increase overall outputs of moderate-to-vigorous physical activity in preadolescents.

Child↗
PubMed2002

Radical concept nativism.

Radical concept nativism is the thesis that virtually all lexical concepts are innate. Notoriously endorsed by Jerry Fodor, radical concept nativism has had few supporters. However, it has proven difficult to say exactly what's wrong with Fodor's argument. We show that previous responses are inadequate on a number of grounds. Chief among these is that they typically do not achieve sufficient distance from Fodor's dialectic, and, as a result, they do not illuminate the central question of how new primitive concepts are acquired. To achieve a fully satisfactory response to Fodor's argument, one has to juxtapose questions about conceptual content with questions about cognitive development. To this end, we formulate a general schema for thinking about how concepts are acquired and then present a detailed illustration.

Concept Formation↗
PubMed2003

Predicting intraindividual self-concept trajectories during adolescence.

The level and stability of both global and domain-specific self-concepts was examined in a study of 253 adolescents, aged 11-20. Intraindividual self-concept trajectories were calculated through growth curve modeling. Six of the self-concept domains were stable over time. In the remaining three domains, there was a significant increase in perceived competency. Growth curve modeling highlighted individual differences in both level and change in self-concept for each of the domains. These differences were partially accounted for by the adolescents' age and gender, suggesting that these variables are important determinants of adolescent self-concept.

Adolescent↗
PubMed1998

Self-concept and social competence of university student victims of childhood physical abuse.

OBJECTIVE: This study examined the impact of childhood physical abuse on self-concept and social competency of older adolescents and assessed perception of parental relationships as a mediator for consequences of abuse on social adjustment. METHOD: College undergraduates (n = 660) completed: (a) the Social Skills Inventory (SSI), a measure of social competence, (b) the Self-Description Questionnaire-III (SDQ-III), a multidimensional measure of self-concept, (c) the parent scales of the Inventory of Parent and Peer Attachment (IPPA), a measure of perceived parental support, and (d) the Assessing Environments-III (AE-III), a retrospective report of family environment and parenting practices. RESULTS: Analyses, controlling for socioeconomic status and ethnicity, showed that a history of physical abuse was predictive of current self-concept, but did not predict social competence as an older adolescent. Further analyses lend support to a mediational model, suggesting that physical abuse has a negative impact on self-concept through its negative effect on parent-child relationships. CONCLUSIONS: The findings indicate that childhood physical abuse has a negative impact on the self-concept of the older adolescent. However, this impact can be better understood by investigating its potentially harmful effect on parent-child relationships. The impact of physical abuse on adolescents' social competence was not supported in this study.

Adolescent↗
PubMed1995

Measurement of the professional self-concept of nurses: developing a measurement instrument.

The professional self-concept of nurses is an important component in the professional and academic development of the nursing profession. Few studies have concentrated on the careful development of the construct of professional self-concept in nurses, using a nursing sample, and particularly an Australian sample. This study focuses on a pilot group of nurses from the Hunter Region of New South Wales to develop the multi-dimensional construct professional self concept of nurses. A 56 item instrument using Likert scales was developed to measure the constructs flexibility/creativity, knowledge, skill/competence, caring, communication, leadership and satisfaction. The instrument was administered to 170 third year students enrolled in a Diploma of Applied Science (Nursing) and the results subjected to item analysis, factor analytical studies, and reliability estimates. Three factors emerged which accounted for 40% of the variance in responses constituting the professional self-concept of nurses: 'professional practice' (incorporating the dimensions leadership, skill and flexibility), 'satisfaction', and 'communication'. The study contains suggestions for the further use and research implications for a 27 item instrument for measuring the professional self-concept of nurses which has demonstrated validity and reliability.

Education, Nursing, Diploma Programs↗
PubMed1996

The self-schema model: a theoretical approach to the self-concept in eating disorders.

Over the last several decades, the self-concept has been implicated as a important determinant of eating disorders (ED). Although considerable progress has been made, questions remain unanswered about the properties of self-concept that distinguish women with an ED from other populations, and mechanisms that link the self-concept to the disordered behaviors. Markus's self-schema model is presented as a theoretical approach to explore the role of the self-concept in ED. To show how the schema model can be integrated with existing work on the self-concept in ED, a framework is proposed that addresses the number, content, and accessibility of the self-schemas. More specifically, it is posited that a limited collection of positive self-schemas available in memory, in combination with a chronically and inflexibly accessible body-weight self-schema, lead to the disordered behaviors associated with anorexia nervosa and bulimia nervosa.

Adolescent↗
PubMed2003

Application of "Concept Mapping" in obese subjects: a pilot study in normo and underreporters.

BACKGROUND: One important step in nutritional education consists in identifying the patient prior knowledge in order to better educate him. The objectives of this pilot study, on twelve obese patients (6 underreporting patients - UR - and 6 normoreporting patients - NR) were to point out advantages and limits of a method: "concept mapping", a graphic representation of the nature and organization of knowledge, and to show eventual cognitive differences between the two groups of patients. METHODS: Concept maps were drawed during interviews and analysed, considering the concepts, the links between them, their regrouping in knowledge fields. Conceps maps of UR and NR patients were compared. RESULTS: Our results confirm the advantages of concept mapping as the mean to explore the cognitive representation of patients. Some differences between UR and NR patients were readable on the maps: UR patients are more sensitive to the difficulties of the diet than the NR patients. UR patients tend to express more frequently their feelings or personal experiences, and to be more easily invaded by their feelings (more numerous links of personal expressions at UR patients). CONCLUSION: Concept mapping brings new information on knowledge of obese patients. They appear important to better know the cognitive representations of underreporting patients. With such information, it would be easier for healthcare providers to adapt educational programs to the patients' understanding, taking into account their misconceptions, errors and lacks of learning.

Adult↗